Cochlear Implant Post-Op Instructions
COCHLEAR IMPLANT POST-OPERATIVE INSTRUCTIONS
Cochlear implant surgery lasts three to four hours and is performed while the patient is under general anesthesia. Some conditions that may affect the cochlea, such as cochlear ossification (bony growth) or cochlear abnormalities may lengthen the time of surgery. A small area behind and above the ear to be implanted is shaved to reduce the possibility of infection near the implant site. The hair grows back naturally over this area.
The surgeon makes a postauricular (behind the ear) incision. A small depression is created in the mastoid bone to hold the receiver/stimulator so that it is flush with the skull. The surgeon drills through the mastoid bone to the inner ear. This mastoidectomy allows access to the inner ear (cochlea) without disturbing the ear canal or eardrum. A very small opening is made into the cochlea and the implant electrode is threaded in as far as possible. Most cochleas can accommodate the complete electrode unless meningitis is the cause of deafness, in which case a partial insertion may be necessary. The receiver/stimulator is secured to the skull and the incision is closed with stitches or staples. A head wrap dressing stays on overnight. Patients are usually able to get out of bed and walk around the day after surgery and generally are discharged from the hospital on the first postoperative day. Pain is mild to moderate for several days and can be controlled with oral pain medicines. We have given you a prescription for a pain medication in the event that Tylenol is not adequate. Do not take aspirin, Advil, Nuprin or similar compounds, as these increase the risk of bleeding.
Some patients experience imbalance for a few days after surgery but this usually resolves spontaneously within the first week. Please keep the incision dry from water exposure, and coat with antibiotic ointment two or three times daily. Exercise and vigorous physical activity should be avoided for four weeks. You should not drive if you are taking pain medicine other than Tylenol, or if you have any dizziness.
Patients generally report that they are at “full-strength” and “back to normal” within a week or two after the surgery. Patients return to school or work as soon as they feel well enough to do so, usually within a week of surgery. Stitches or staples are removed approximately 10 days after surgery. Activation of the implant takes place four to six weeks after implantation. The four to six week recovery period permits complete healing around the implant site before the patient returns to the clinic to be fitted with the external components of the system. Programming of the external speech processor is performed by the audiologist. The patient will begin to hear their first sounds from the implant. The implant system is programmed to suit each individual’s needs. The implant team continues to work with the implant recipient as long as it is necessary to ensure optimal benefit from the device.
Patients generally fell better day-to-day. Please call us for fever, bleeding, discharge, increased pain or swelling, or any concerns you may have.
RISKS AND COMPLICATIONS OF COCHLEAR IMPLANT SURGERY
Cochlear implantation procedures have been performed for over 25 years and are considered safe and effective. Overall, cochlear implantation is a very safe procedure. Every patient must realize, however, that as with any surgery or procedure, there is a small risk of surgical complications during cochlear implantation. The risks of cochlear implant surgery are the same as those associated with any major ear surgery requiring general anesthesia. These risks include but are not limited to:
The normal risks of general anesthesia. This is a very small risk with the modern anesthesia techniques used today. These risks are increased in patients with a family history of adverse reactions to anesthesia, and in patients who are very ill. Most patients undergoing cochlear implantation are healthy and have no difficulty with the anesthesia.
Temporary dizziness and/or temporary disturbance of balance. Dizziness and nausea are fairly common after cochlear implantation. This is due to manipulation of the inner ear. This usually resolves quickly unless balance was poor before surgery.
Temporary increase in tinnitus or ringing in the ear. This also is due to manipulation of the inner ear.
Numbness in area of scar. Major ear surgery often results in numbness and discomfort around the ear. There will be tenderness around the incision site and many patients have a mild headache for several days after the implant. These symptoms usually subside within a few weeks after the surgery.
Change in taste sensation. There is a slight risk that the patient may experience taste disturbances, such as a metallic taste, following the implant surgery.
Risk of bleeding and infection. The bleeding is usually minimal and does not require transfusion. Infections can be treated with antibiotics and local wound care. Severe infections of the device may require its removal, but this is very unusual.
Facial nerve bruising. This nerve running near the site of surgery is carefully monitored throughout the operation. This ensures that bruising of the facial nerve is highly unlikely. In the rare case of injury, some changes to facial nerve function may be permanent.
Device failure. Any man-made device can fail, break or function improperly. This could necessitate removal and/or replacement of the device. The device failure rate is very low.
Loss of hearing. During surgery any remaining hearing in the implanted ear will be permanently lost.
Disclaimer: These Post-Operative Instructions are for patients of record at our practice only. If you are not a patient of Ear Consultants of CNY, please contact your own surgeon for specific instructions.